NPIMap

Organization Active NPI

Champaign Residential Services Inc

Doing business as Crsi

  • Intellectual Disabilities Intermediate Care Facility
  • Tiffin, OH
National Provider Identifier
1871964650
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
CHAMPAIGN RESIDENTIAL SERVICES INC
Doing business as
Crsi
Practice address
12 Orchard Park
Tiffin, OH 44883
Phone
(937) 653-1320
Fax
(937) 653-1321
NPI assigned
Oct 19, 2015
Last updated
Oct 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Scott A Delong
Title
President
Phone
(937) 653-1320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X OH Primary

Addresses

Primary practice location

12 Orchard Park
Tiffin, OH 44883

Mailing address

1150 Scioto St
PO Box 29
Urbana, OH 43078-2289
Phone (937) 653-1320

Other names 1

  • CRSI Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Champaign Residential S18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1871964650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 SCIOTO ST",
            "address_2": "PO BOX 29",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430782289",
            "telephone_number": "937-653-1320",
            "fax_number": "937-653-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ORCHARD PARK",
            "city": "TIFFIN",
            "state": "OH",
            "postal_code": "44883",
            "telephone_number": "937-653-1320",
            "fax_number": "937-653-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPAIGN RESIDENTIAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "DELONG",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-653-1320"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRSI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tiffin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.